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Full text of "Navy & Marine Corps Medical News 00-26"

The United States Navy on the World Wide Web 
A service of the Navy Office of Information, Washington DC 
send feedback/questions to coinments@chinfo.navy.mil 
The United States Navy web site is found on the Internet at 

http: //www. navy.mil 



Navy & Marine Corps Medical News 

MN-00-26 
June 30, 2000 

This message has been coordinated with the commandant of 
the Marine Corps (CMC) . The commandant has authorized 
transmission to Marine Corps activities. 

Navy and Marine Corps Medical News (MEDNEWS) is a weekly 
compendium of news and information contributed by commands 
throughout the Navy Medical department . Information contained 
in MEDNEWS stories is not necessarily endorsed by BUMED, 
nor should it be considered official Navy policy. 

The Navy Bureau of Medicine and Surgery distributes MEDNEWS 
to Sailors and Marines, their families, civilian employees and 
retired Navy and Marine Corps families . Further distribution 
is highly encouraged. 

Stories in MEDNEWS use these abbreviations after a Navy 
medical professional ' s name to show affiliation: MC — 
Medical Corps (physician) ; DC - Dental Corps; NC - Nurse 
Corps; MSC - Medical Service Corps (clinicians, researchers 
and administrative managers) . Hospital Corpsmen (HM) and 
Dental Technician (DT) designators are placed in front of 
their names. 

-USN- 

Contents for this week's MEDNEWS: 

— Experimental medical information systems tested during RIMPAC 2000 

— Pacific military treatment facilities now under one survey 

— Addiction treatment facility opening its door to entire defense family 

— Foreign nurses oriented in Orient 

— Great Lakes corpsmen lend support to recruiting efforts 

— Two new sites expand FEHBP military retiree demo 

— 2000 edition of U.S. Navy shipboard pest control manual is available 

— TRICARE question and answer 

— Anthrax question and answer 

— Healthwatch: Some known and little known facts about calcium 

-USN- 

Stories: 

Experimental medical information systems tested during RIMPAC 
2000 

By J02 (SS) Dave Kaylor, RIMPAC 2000 Combined Information 
Bureau 

The international maritime exercise Rim of the Pacific 
(RIMPAC) 2000 served as the testing ground for hi-tech 
medical experiments funded by the Defense Advanced Research 
Projects Agency (DARPA) . 



The experiments are in various stages of development, 
according to 3rd Fleet Surgeon, Lt.Cmdr. Eric Rasmussen. 
They exhibited varying degrees of success, but all performed 
better then expected. 

The staging ground for these experiments was "Strong 
Angel, " a humanitarian refugee assistance exercise conducted 
in a barren region on the big island of Hawaii . The 
interagency exercise included a number of United Nations and 
non— governmental organizations. "Strong Angel" marked the 
first time a humanitarian exercise was an integral part of 
RIMPAC. 

"We were able to build a large scale exercise, " said 
Rasmussen, "because we had experimentation funding. " 

Three of the experiments in particular were highlights 
during the humanitarian exercise. The first was a simple 
phrase-based translation system. In a refugee situation like 
the one simulated in "Strong Angel, " a care provider can 
communicate with non— English speaking refugees. 

A corpsman speaks a particular phrase into the built— in 
microphone on a Fujitsu 2300 tablet. The phrase is then 
translated and played back in the selected language. For 
example, the corpsman might say in English to a Swahili 
speaking refugee, "I am a member of the North Atlantic 
Treaty Organization peace keeping forces. " The refugee would 
then hear that phrase translated into Swahili . 

It is designed to be a screening system allowing a care 
provider to quickly extract simple registration information 
from refugees. It communicates in either short statements or 
solicits simple answers to general questions. If it is 
determined that more information from a particular 
individual is needed, that person would then be sent to a 
table set up with the two— way translation system. 

"It's a simple way to do 20 questions, " said Rasmussen. 
"The result has been a fairly robust 20 question system 
where you and I can be mute, not have one word in common, 
but still communicate with each other. It worked 
beautifully . We will be pushing it forward, probably into 
central Africa in November . " 

Also performing well during the exercise was the two- 
way translation system. Much more complicated, it consists 
of two side-by-side laptops. English is spoken into a 
headset attached to the first laptop. After recording the 
information utilizing voice recognition software, the 
con^uter then translates it into the selected language and 
plays it back through the speaker of the second laptop, 
enabling a two-way conversation between individuals speaking 
different languages . At this early stage, Korean is the only 
language to be translated in the new system. 

"That 's because we needed a huge body of parallel 
information, " said Rasmussen. "It turns out that the best 
examples were the twice daily battle briefings given in 
South Korea. U.S. Forces and Republic of Korea Forces are 
given those briefings simultaneously in English and Korean. 
Those were absolutely perfect translations with a body of 



translators standing by to assist. " 

After feeding the simultaneous information into the 
computers, the next step was to build statistical 
translation models. Many of the Korean officers used to 
evaluate the new system during its development are now 
participants in RIMPAC 2000. 

Interactive Drama, named after the Maryland company 
responsible for its development, is another experiment 
consisting of pre— recorded information on a topic stored on 
a digital video disc (DVD) . One of its first applications 
would be to evaluate chemical weapon exposures far forward. 

A subject-matter expert records the audio-visual 
information. When the information is needed, a battlefield 
medic asks questions into a microphone attached to the 
laptop. Voice recognition techniques allow the system to 
retrieve the appropriate information from the DVD. The 
information is then played back showing the expert answering 
the question. 

"Its just as if there is a two-way conversation between 
the subject matter expert and the person asking the 
question, " said Rasmussen. "It looks like an interactive 
television show, driven by voice. It's in the early stages 
of development, so we didn't expect much, but it did fine." 

One important aspect of these three systems is that 
they all use standard off-the-shelf hardware. Other than the 
specific software, all the equipment is non-proprietary, 
making the systems easier to operate and maintain. 

"We had an extremely successful set of experiments 
because we scoped it carefully and we knew what we were 
trying to achieve, " said Rasmussen. "We even survived the 
dust . " 

-USN- 

Pacific military treatment facilities now under one survey 
By Bill Doughty, U. S. Naval Hospital Yokosuka, Japan 

YOKOSUKA, Japan - A small percentage of patients 
throughout mainland Japan are being randomly selected and 
mailed an individualized, customized survey to help assess 
the quality of care and provide feedback to hospital 
personnel . 

The 17 multiple-choice questions survey replaces the 
small, local surveys done by each command or clinic in the 
Pacific. 

"It's important that you fill it out. It helps us know 
what the quality of care we're providing and whether or not 
we're providing good access to care," said Lt. Paul Toland, 
Head of Managed Care. 

"Although information is collected independently, USNH 
Yokosuka will get a report and an overall score that will 
benchmark them against other facilities throughout the 
Military Health System, " said LT Toland. The survey will 
also help the hospital measure TRICARE Prime access goals 
and patients ' overall satisfaction with customer service. 



"When we get the information we're going to look at the 
areas that are identified as trouble areas where we're not 
meeting the goals of the Military Health System. And in 
those areas we 're going to target for performance 
improvement, " said LT Toland. "But, it ' s also important for 
us to know the areas that where are excelling in so we can 
continue to excel in those areas and share them with 
others. " 

For more information on the outpatient satisfaction 
surveys, contact your TRICARE Service Center or visit the 
TRICARE web page at www. tricare . osd.mil/tricaresurveys . 

-USN- 

Addiction treatment facility opening its door to all 
benefi claries 

By Rod Duren, Naval Hospital Pensacola 

PENSACOLA, Fla. — Naval Hospital Pensacola 's Addiction 
Treatment Facility (ATF) has extended its substance 
treatment programs to all military members, retirees and 
their family members over age 18. 

"As a part the naval hospital 's continuing efforts to 
meet the needs of the entire Navy community, we are very 
pleased to extend what is usually an 'active-duty only' 
medical service," said Commanding Officer Capt. Robert D. 
Hufstader. 

The Addiction Treatment Facility is a mid-sized Navy 
unit with 13 counselors and 22 overall staff. But it is 
among the "very few who are providing services for non- 
active duty people, " said Cmdr. H. Wakeman Smoot, 
psychiatrist and the ATF's Department Head. 

"Although we are obviously excited to see this 
department grow and take on the new challenges, " the 
decision to extend the services is "clearly being done to 
benefit the community, " said Smoot . 

The ATF provides intensive counseling and intervention 
on an outpatient basis for persons addicted to or abusive of 
(primarily) alcohol. Although not currently offering in- 
patient or residential care locally, the ATF can serve as a 
liaison to other facilities, both military and civilian, 
that offer that level of care. 

"The Navy's drug and alcohol treatment programs are 
among the best in the country. In fact. Navy alcohol 
treatment programs were the prototype for most of the 
country's successful treatment approaches, " said Hufstader. 
"I'm pleased that we're able to open this excellent service 
to even more of our people. " 

Opening the ATF to the Navy Pensacola community, the 
Naval Hospital is hoping to raise the awareness level and 
scope of treatment to the next plane in order to assist 
others in their fight against these addictions. 

-USN- 

Foreign nurses oriented in Orient 



By Cmdr. Angela Alsberry, NC, Branch Medical Clinic Atsugi 



ATSUGI, Japan — Seven nurses of the Foreign Nurses 
Association of Japan (FNAJ) attended a special Red Cross 
orientation program June 13 at Branch Medical Clinic Atsugi, 
to become certified volunteers. 

According to Commanding Officer Captain Hank M. 
Chinnery , this union of the BMC Atsugi and the FNAJ is a 
wonderful opportunity to learn of nursing both in the 
Military Healthcare setting and also the way of nursing in 
other countries of the world. Having the nurses come to us 
broadens our outreach to those professionals who seek to 
remain active in giving patient care. 

The FNAJ is composed of about 40 registered nurses from 
around the world who are in Japan for unique reasons. Those 
participating in March and last week were from the U.K., the 
Philippines, Australia, U.S., Korea and Japan. Some of these 
nurses have lived and worked in countries such as Saudia 
Arabia, Malaysia and Central America. 

At the conclusion of the day, all received 
certification as BMC Atsugi Red Cross Volunteers. 

-USN- 

Great Lakes corpsmen lend support to recruiting efforts 
By Lt . Youssef H. Aboul-Enein, MSC, Naval Hospital PAO 

GREAT LAKES, 111 . — The Great Lakes Summer Cruise 2000 
hosted the USS DEFENDER (MCM-2) and USS KINGFISHER (MHC-56) 
as part of its annual high school recruiting campaign the 
first week of June at Chicago's Navy Pier. 

Over 250, 000 attended the week— long event . Young men 
and women talked with the Great Lakes Corpsmen about the 
many specialties within the rating such as operating room 
technician, respiratory technician and optometry technician. 

"Navy Medicine is one of the many ways to realize your 
dreams of becoming a physician, nurse or one of the many 
allied health specialties, " said HMl Jacque Dubose to a 
group of high school students. 

The students toured the ships and a nearby tent manned 
by over 20 Navy corpsmen and dental technician from Naval 
Hospital Great Lakes, Naval Hospital Corps School and Naval 
Dental Center Great Lakes displaying career and education 
information 

"The medical tent was very popular because they have 
displays and hand-outs that interest young men and women who 
can identify a career and skills that can be used in the 
civilian world, " said DTI Cheryl Castillo. "Many of the 
high school kids and their parents do not realize there is a 
dental rating in the Navy and the career opportunities it 
provides such as a two— year program which offers a diploma 
as a dental hygienist, " said Castillo . 

Naval Hospital Great Lakes medical and dental commands, 
where healthcare begins for over 53, 000 recruits a year, are 
inextricably linked to the recruiting efforts such as the 



Great Lakes Summer Cruise 2000. 

-USN- 

Two new sites expand FEHBP military retiree demo 
From Office of the Assistant Secretary of Defense 

WASHINGTON - In a move to expand alternative health 
care options to military retirees over 65, the Department of 
Defense announced that it recently expanded the Federal 
Employee Health Benefit Program (FEHBP) demonstration 
project to include two new over— 65 military retiree 
demonstration sites. 

These additional sites are in the surrounding ZIP code 
areas of Coffee County, Ga., and Adair County, Iowa. They 
expand one of the department ' s projects to determine the 
most feasible way to provide health care for uniformed 
services Medicare-eligible beneficiaries and certain others. 
Members of the Military Coalition and the National 
Military/Veterans Alliance, two consortiums of organizations 
representing TRICARE beneficiaries, randomly selected "seed" 
areas for the additional program sites in early April. 

This congressionally mandated demonstration project 
allows certain eligible uniformed services beneficiaries to 
enroll in, and receive their health care through, a health 
plan in the FEHBP, the same program used by civilian federal 
employees and retirees . DoD will contribute the standard 
government amount, which is almost three— quarters of the 
pi an ' s premi um . 

The expanded demonstration will target e±>out 25, 000 
eligible beneficiaries in each location, increasing to 
120, 000 the number of beneficiaries eligible for the FEHBP 
demonstration. The Iowa site encompasses the entire state 
(except ZIP code areas in the Offutt Air Force Base's 
catchment area) , parts of Minnesota, South Dakota, Nebraska, 
Kansas and Missouri. 

The second site includes parts of Georgia, Florida and 
South Carolina. 

The next enrollment opportunity at all demonstration 
sites, including the two new ones, will begin in November 
2000 during the FEHBP 's annual enrollment open season. 
Coverage for new participants will begin Jan. 1, 2001, and 
will run through Dec. 31, 2002. The U.S. Office of Personnel 
Management (OPM) administers the FEHBP. OPM and DoD jointly 
administer the DoD/FEHBP demonstration project . 

This fall, DoD will mail "The 2001 Guide to Federal 
Employees Health Benefits Plans participating in the 
DoD/FEHBP Demonstration Project " to all eligible persons 
within the designated ZIP code areas. The guide contains a 
list of participating health plans, benefits, premiums and 
other information. 

Information will be available in late summer on a 
series of meetings about the project that will be held in 
the areas of the new demonstration sites. Beneficiaries who 
meet eligibility criteria will receive notification by mail . 



others may call the DoD/FEHBP Project Call Center toll-free, 
1 (877) 363-3342, for further information. 

For a complete list of ZIP code areas to be served by 
the new demonstration sites, and other information about the 
FEHBP demonstrations, visit the Military Health System 
website : www. tricare . osd.mil/fehbp/ 

-USN- 

2000 edition of U.S. Navy Shipboard Pest Control Manual 
available 

The Navy Disease Vector Ecology and Control Center 
Bangor has released the 2000 edition of the U.S. Navy 
Shipboard Pest Control Manual . 

This is the first new edition since 1984. The Shipboard 
Pest Control Manual is a comprehensive reference that covers 
all aspects of pest control for U.S. Navy Ships. The manual 
is a companion to the Shipboard Pest Management Course (CIN 
B— 322-2075) . Numerous color photos of pests and pest control 
subjects have been added. The biology of the major 
shipboard pests, such as cockroaches, rats and stored 
product pests are covered. 

All of the chapters have been updated with new and 
improved pest meLnagement techniques merged with the bedrock 
principles of pest management . A new chapter on quarantine 
issues has been added that covers background information on 
quarantine responsibilities of the Navy. 

The manual also includes the Navy Environmental Health 
Center approved Authorized Shipboard Pesticide list . Copies 
of the manual will be made available at Shipboard Pest 
Management classes. To register for a Shipboard Pest 
Management class contact your local medical entomologist at 
a Navy Disease Vector Ecology and Control Center or Navy 
Environmental and Preventive Medicine Unit . The manual is 
also available for download at the NDVECC Bangor website, 
www. ndvecc . navy.mil . 

-USN- 

TRICARE question and answer 

Question: Is preventive care covered under Standard or 
Extra? 

Answer: Preventive care is an added benefit under Prime. If 
the particular preventive service is a benefit included 
under the TRICARE Standard (CHAMPUS) benefits, you will be 
responsible for the deductible and co-payment under Extra 
and Standard. See your Health Benefits Representative about 
specific preventive care under TRICARE Standard. 

-USN- 

Anthrax question and answer 

Question: Why do we think the anthrax vaccine will protect 
people if anthrax inhalation occurs? What scientific 



evidence do we have? 

Answer: The original Brachman and CDC studies of anthrax 
vaccine in textile workers proved that the vaccine protected 
against anthrax. The calculations performed in that study 
combined the cutaneous (skin) and inhalation forms of 
anthrax infection that occurred. No inhalation anthrax 
occurred among the vaccinated workers, while five cases of 
inhalation anthrax occurred among workers who had not been 
vaccinated. The total number of cases was judged too few to 
show statistically conclusive proof of protection. 

However, results from several animal studies provide 
additional evidence that the vaccine protects against 
anthrax challenge with more than 500 times the lethal dose 
of anthrax by inhalation. This information coupled with the 
encouraging results of the effectiveness and immune response 
in humans assures us that the vaccine will greatly increase 
the chances of servicemembers surviving exposure to 
inhalation anthrax. When full immunization is combined with 
proper use of protective masks, detection devices, 
surveillance and post-exposure treatment with antibiotics, 
the threat is even further reduced. 

-USN- 

Healthwatch: Some known and little known facts about calcium 

Calcium is the most abundant mineral in the human body. 
About 99 percent of the body's calcium is in the bones and 
the rest is in the soft tissues. Most people know that 
calcium is needed for building and maintaining bones and 
teeth. But did you know that calcium also: 

— Helps regulate the heartbeat (along with magnesium) 

— Helps the blood clot and maintain a balance of acid 
and alkali 

— Helps muscles grow and contract 

— Helps nerves transmit 

— Helps the body use iron 

— Helps activate several enzymes (so other nutrients 
can function) 

— Helps regulate the passage of nutrients in and out of 
the cell walls ? 

The calcium that does all this work circulates in the 
blood, and the body regulates the level of blood calcium 
very carefully. Extra calcium is stored in the bones, where 
it can be released quickly if the level of calcium in the 
blood drops too low. 

Despite its importance to the human body, calcium is 
available in significant amounts from very few foods. Most 
people think of dairy products as sources of calcium, and 
milk, yogurt, hard cheeses, and cottage cheese are excellent 
sources. However, not all dairy products are good sources of 
calcium. For example, butter, sour cream and cream cheese 
contain minimal amounts of the minerals. Nondairy sources of 
calcium include broccoli, dark green leafy vegetables, tofu, 
beans, peas, lentils and canned fish with soft edible bones. 



As you get older, your body's ability to absorb 
nutrients declines, so you need to take more calcium. 
Adequate calcium helps prevent osteoporosis, a disease that 
causes the bones to become porous and fragile because 
calcium is withdrawn faster than it is deposited. 

On the other had, too much calcium in your diet can 
result in hypercalcemia, an excessive buildup of calcium in 
the bones and some tissues, such as the kidneys. People who 
rely on tablets or other supplements to supply calcium, 
instead of relying on dietary sources, may be more prone to 
this condition. 

When it comes to calcium, as well as other important 
nutrients, the best advice is to eat a varied but balanced 
diet that 's rich in complex carbohydrates, low in fat, and 
includes moderate amounts of protein. 

-USN- 

Comments about and ideas for MEDNEWS are welcome . Story 
submissions are encouraged. Contact MEDNEWS editor, at 
email: mednews@us.med.navy.mil; Telephone 202/762—3218, 
(DSN) 762, or fax 202/762-3224. 

-USN-